Having the ability to extend the thoracic spine is a game changer for many people, especially for those who tend to be sequestered for hours on end in front of a computer on a day-to-day basis.
For lack of a better term, a lot of cool shit happens with extension:
The shoulder blades can retract and upwardly rotate.
It’s much easier to get the arms overhead.
It’s easier to keep the chest up during squats and deadlifts.
It makes for a “better” bench press. I.e., shoulder blades can retract and depress providing a more stable base of support.
It makes you 17.2% more attractive.[footnote]Look it up on PubMed.[/footnote]
The thoracic spine (thorax for the nerds in the room) is the “anchor” of the shoulder blades. Ideally we like to see congruency between the ribcage/thorax/t-spine/whatchamacalit and the shoulder blades.
When someone is a bit more kyphotic (rounded) in that area it makes it almost impossible for this to happen because the shoulder blades will often be more abducted and anteriorly tilted.
This can setoff a domino effect of other shenanigans such as a narrowing of the acromion space (for example), which in turn leads to rotator cuff issues, which then leads to not being able to bench press without pain, which, as we all know, means the Apocalypse is upon us.
Let’s avoid the Apocalypse.
To that end I’d like to take this time to share some of my “go to” T-Spine Extension drills I use with my own clients and athletes on a weekly basis.
1. T-Spine Extension Off a Foam Roller (Performed In a Way That Doesn’t Make Me Want to Swallow Live Bees)
Likely the most recognizable drill many gravitate towards – and for good reason (it’s a good one) – is T-Spine Extension off a foam roller.
However, many tend to go waaaaaaay too far with their total range of motion on this to where it becomes more of a lumbar spine movement.
Here’s how to do it correctly:
2. Prone T-Spine Extension
I reserve “fancy” for choosing a nice restaurant for a date night with my wife.[footnote]You know, something like Applebees.[/footnote]
I don’t feel the need to get fancy with my T-spine extension drills.
The Prone T-Spine Extension drill is a fantastic way to build mid-back endurance.
3. Child’s Pose Back Extension Off Med Ball
What’s great about this variation is that when we adopt the “child’s pose” (knees tucked underneath) we OMIT the lumbar spine.
So now the only area we can get movement is the t-spine.
4. Pigeon Stance w/ Reach Through & Extension
Taking the previous concept and upping the ante a little bit is this exercise I “stole” from Dean Somerset.
If we want to talk about a drill that provides a TON of benefit for our training buck this is it.
Here we get a stellar hip mobility/glute stretch, while at the same time taking the lumbar spine out of the equation (because that’s NOT where we want movement from).
Too, with the reach through (and then extension) we’re getting a double whammy effect of mid-back mobility goodness.
NOTE: I like to add in an inhale (through the nose) on the reach through and then a FULL exhale (out the mouth) as the individual extends back up.
NOTE #2: My tricep looks fucking amazing in this video.
5. Wall T-Spine Extension w/ Lift Off
This drill is a doozy as well.
Pushing the hips back and “settling” into your accessible t-spine extension ROM is money enough for most people. But when you add in the end-range “lift off” (lifting the hands off the wall) at the end, it adds that little “eff you” component not many people will like.
Be careful not to crank through your lower back on this one!
This one is more challenging than it looks, so way on the side of conservative when choosing the loads you use.
I’m using a 10 kg kettlebell in this video and am pretty sure I blacked out after shooting this video.
Want More Shoulder Magic?
Join me IN-PERSON for two upcoming Fall workshops I am putting on. I cover shoulder/hip assessment, programming strategies, the concept of the TRAINABLE MENU, favorite Decepticons, and much, much more.
Without going too far down the rabbit hole (and without a PubMed reference in site), I have been “caught” saying a time or two that 99% of the shoulder issues I come across – whether working with an overhead athlete or Martin from Tort-Law-R-Us[footnote]If this doesn’t exist, it should.[/footnote] – has it’s roots in what the shoulder blades are (or in most cases) are not doing.
For a myriad of reasons most of us have been programmed to think that “shoulder blades together AND down” is the end-all-be-all of shoulder health.
It works splendidly when 1) you’re working with someone who’s stuck in a more flexed/rounded/computer guy posture and/or 2) the goal is to lift as much weight as humanly possible.
I.e., good luck bench pressing (or even squatting/deadlifting) appreciable weight with shoulder blades that aren’t “set” in a more stable position.
That being said, too much of anything can have its inherent drawbacks.[footnote]Except for LOLCat memes. And He-Man cartoons. Oh, and foot massages.[/footnote]
The “together and down” cue can lead to overactive lats and a more extension-based pattern where the shoulder blades get stuck or “cemented” together – making it all the more challenging for them to freely move about the rib cage (which they’re designed to do).
The scapulae are meant to move:
Upward/downward rotation
Protraction/retraction
Anterior/posterior tilt
However, they often get “stuck” in a more downwardly rotated and retracted position from all the “down and back” cueing we’ve been inundated with.
One drill I have been using to help “un-glue” the shoulder blades is this one:
Band Assisted Scapular Upward Rotation
Who Did I Steal It From? – Dr. Michael Mash from his excellent Barbell Rehab course.
What Does It Do? This is such a simple drill to implement and works well with pretty much everyone. Except Orcs (for obvious reasons).
The pulldown trains scapular downward rotation and retraction, which is all well and good. I’m not a hater. It’s the reverse action, though, using the accentuated eccentric to emphasize scapular PROTRACTION and UPWARD rotation (with the assist from the band) that makes it a truly unique exercise to considering using.
This drill helps improve the full spectrum of scapular motion as well as to help gain “access” to overhead range of motion in general.
Key Coaching Cues: Attach a band to the top of a squat rack (or anything that doesn’t move) and sit directly underneath. From there, pull down as you normally would, but then SLOWLY resist the pull of the band as you allow it to pull your arm fully up overhead.
I was going to run with the title “3 Unconventional Shoulder Health Exercises (That Aren’t Band External Rotations)” but I didn’t want to come across as a pompous a-hole.
😉
Alternatively, I was considering “3 Unconventional Shoulder Health Exercises (That Aren’t Band External Rotations) and STOP DOING KIPPING PULL-UPS FOR THE LOVE OF GOD.”
Just so we’re on the same page: I am NOT against external rotation drills (band, side lying, whatever else you can come up with here).
On the contrary I use them often when working with clients who exhibit shoulder discomfort or have a lengthy history of shoulder pain – specifically with the rotator cuff.
Many EMG studies have shown that when it comes to activation…
…Side Lying External Rotations are the Don Corleone of rotator cuff exercises.
They’re wonderful and are a home-run for most people, most of the time (when done correctly). They’re also, you know, about as exciting as watching another parent’s kid’s Clarinet recital.
No one gets excited to head to the gym to perform Side Lying External Rotations. You can make them more palatable, of course:
But even still…
…ZZZzzzzzz.
I’m a firm believer that training, especially rehab, should look (and feel) like training. So today I wanted to pass along a few drills I think you should add to your repertoire.
1. Seated Reach & Row
I got this one from strength coach (and person who makes me feel like an old curmudgeon), Conor Harris.
I’m starting to fall into the camp that addressing Serratus weakness is the answer to everything:
Shoulder pain?
Neck pain?
Back pain?
Lawnmower won’t start?
More Serratus work my friend!
Reaching (or protraction) is a bonafide way to target the Serratus anterior and improve shoulder health. Likewise, working on ribcage expansion is also part of the equation.
The ribcage is shaped in a convex manner.
The scapulae (shoulder blade) is concave, or rounded, in nature. The ability for the two to play nicely together is an often overlooked mechanism of what I like to call “my shoulder fucking hurts syndrome.”
A stiff ribcage can lead to one of two things:
Lack of rotation.
Inability to expand during inhalation.
BONUS: Also less likely to win an arm-wrestling match vs. a Lumberjack. Trust me.
By combining a reach with an alternating row (and then adding a pause to INHALE in order to induce posterior expansion of the ribcage) we can sorta “unglue” it, which can have profound implications (in a good way) to shoulder health; namely, the scapulae have an increased ability to move.
I think we’ve been programmed to think that shoulder health begins and ends with rotator cuff. I’d make the case that the more germane approach – or attack point – is to address scapular function via the ribcage.
If the ribcage can’t move, neither can your shoulder blades.
2. Elbows Up Banded Press
Pigging back off my Serratus obsession above (<– totally not creepy),[footnote]Okay, it’s creepy[/footnote]here’s a splendid drill I stole from my friend (and person I hate because he’s way stronger than me), Dr. Jonathan Mike.
Too, what I dig about this exercise is that it very much has a meathead vibe to it.
OMG – the pump you feel after performing a set of these is insane.
After a killer upper-body session, instead of Band External Rotation drills, do this for 2-3 sets of 10-20 reps.
3. 1-Arm Band Upper Cut
This is a drill I’ll often pair with things like squats or deadlifts. Both entail “setting” the shoulder blades in place in a more downwardly rotated (or depressed) position.
This is ideal for lifting heavy things – and for keeping the joint “safe” – but as I alluded to above, not for overall shoulder health.
The scapulae are meant to move in a myriad of ways up, down, and around the ribcage.
The Banded Upper Cut not only targets the Serratus (reaching), but also the upper traps which aid with scapular UPWARD rotation.
The key is to make the movement one seamless movement by thinking about directing everything through the pinky finger. I like to tell clients to think about pointing their pinky out in front of them…
…then UP towards the ceiling.
This ensures the shoulder blades moves around (and up) the ribcage. It feels great.
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If you have a shoulder (or two) chances are there’s been a time in your life where things haven’t felt great. This sentiment is only amplified if you happen to be someone who lives an active lifestyle playing sports and/or enjoys lifting heavy things.
There are a myriad of culprits that can lead to shoulder pain.[footnote]Poor or limited thoracic mobility, glenohumeral weakness, acromion type, programming imbalances, technique flaws, Thursdays, lots of stuff.[/footnote]
Likewise, there are a myriad of solutions.[footnote]Improving thoracic mobility, improved breathing patterns, general strengthening, you’re related to Gandalf, etc.[/footnote]
For me, almost always, I find the “fix” for most people is improving their scapular kinematics; specifically scapular upward rotation and protraction.
One of the staple drills I like to use to accomplish the above (scapular upward rotation & protraction) is the Forearm Wall Slide.
Admittedly, it’s a simple looking thingamabobber of a drill.
I mean, all you do is move your arms up and down on a foam roller, right?
Weeeeeeeeeeeeeeeeeeee.
Alas, simple in appearance, not so simple in execution.
TOP VIDEO showcases two common faults I see when most people perform this drill.
❌ Reps 1-3 = depressed or “pinned down” scapula. Incessantly cueing your clients/athletes to retract & depress the shoulder blades has ramifications.
Sure, it’s an excellent cue to lift a metric shit ton of weight. There’s a reason why we tell people to bring their shoulder blades together and down during a bench press.
However, the scapula is meant to move around the ribcage and it’s imperative for overall shoulder health. When someone is pelted over the head with “together & down, together & down” cues the end result is a shoulder blade that’s cemented in a downwardly rotated position.
This can (not always) lead to shoulder ouchies.
❌ Reps 4-6 = shrugging pattern. The upper traps do play a significant role in shrugging (elevation). Shrugging, however, is NOT upward rotation.
In both scenarios there’s no “real” upward rotation happening.
The drill is ineffective.
Bye, Felicia.
BOTTOM VIDEO showcases what we actually want to see happen.
I like to cue people to “reach” towards the ceiling through their pinky finger, and then to sorta lean into the wall as the arm straightens overhead.
Here we get the upper trap to kick in more effectively and we can now see a shoulder blade that’s upwardly rotating (and moving around the rib cage via protraction & Serratus activation).
Performing with shirt off = 37% more Serratus Anterior activation. #science.
It’s crucial when choosing certain drills – even the seemingly simple looking ones – that they’re executed the right way. The details and nuances matter.
In fact, you can purchase that OR the combo pack (includes both version 1.0 & 2.0) for a hefty discount in addition to taking advantage of a payment plan option.
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Anyone who’s been lifting weights for a significant amount of time will, at some point or another, have a shoulder (or two) that isn’t too pleased with them.
Sometimes it’s a niggle —> you know, something that doesn’t feel good but also isn’t something that’s going to derail your workout plans.,
Sometimes it’s a lot more than a niggle —> but you’re an idiot and proceed to max effort bench press anyway; you idiot.
Needless to say, niggles happen – to varying degrees. Here are a few short-n-sweet preventative measures you can implement TODAY to keep your shoulders from hating you.
1. You Can Never Do Enough Rows
A simple audit of one’s program often gives a lot of insight.
It’s no surprise that the bulk of people who come to me with cranky shoulders tend to have a programming issue. Meaning, they perform a lot more pressing compared to pulling movements.
In other words: People like to train the muscles they can see in the mirror.
This can lead to an infatuation of sorts with pressing movements.
I find it rarely ever hurts to add more ROWING variations into everyone’s programs. A one-to-one (pull:push) ratio is a nice starting point. However, a 2:1 or even 3:1 (pull:push) ratio is often what’s needed.
We need to take an UNBALANCED approach to “balance” things.
In other words: More rowing variations.
Sometimes it’ll be something heavy – Seal Rows, Bent Over Rows, DB Rows, Seated Rows, Chest Supported Rows.
Sometimes it’ll be something medium – TRX Rows, Face Pulls
NOTE: This isn’t to imply that the exercises listed after “heavy” can only be done heavy and that the ones listed after “medium” can’t be performed with more challenging loads. Rather it’s just to point out that those exercises tend to be better suited for those type of loading parameters.
And sometimes it’ll be an exercise that is better suited for “lighter” loads.
Like this:
Split Stance 1-Arm Band Row
2. Reaching = MONEY for Shoulder Health
I wrote about this in detail a few weeks ago in THIS article, but you probably didn’t read it because I titled it something lame:
“Exercises You Should Be Doing: This Is One That Will Make Your Shoulders Feel Better”
See? Lame.
What I should have done is title it something like:
“101 Bicep Variations That’ll Make More People Swipe Right on Your Tinder Profile.”
And then I would have LOL’d because you would have been expecting an article on how to build swole biceps and what you would have really have clicked on is an article about the Serratus and the benefits of reaching for shoulder health.
Inspired by my good friend and Baltimore based personal trainer, Sivan Fagan, this is a SUPERB movement prep series to get your shoulders primed and ready to handle some subsequent big boy (or girl) weights.
Or if you just want a good ol’ fashioned shoulder pump.
All good.
4. The Arm Bar
Outside of sounding like an 80’s WWF finishing move, this is easily one of the most under-rated exercises for shoulder health out there.
I like to use this one as an extended warm-up for those clients with a history of shoulder issues because it hits a few major big rocks:
Grip (irradiation = more rotator cuff activation).
Trains the rotator cuff in a more “functional” manner (keeping humeral head centered in glenoid fossa).
Scapular stability (I actually like adding a reach/protraction at the top to help train scapular motion AROUND THE RIBCAGE)
Thoracic mobility (namely extension; great for those stuck in front of a computer for hours on end).
Julian is LOCKED IN to Spiderverse over there in the corner.
5. Following a Ketogenic Diet
The fuck outta here with that nonsense.
6. Bottoms-Up Carry Variations
I love bottoms-up carries because they’re a supreme way to train the shoulders in a more “functional” manner with minimal load.
There aren’t many exercises more humbling than this.
When it comes to overall shoulder health there are a bevy of factors to consider:
Rotator cuff strength
Tissue quality
Overuse
Programming balance
Even exercise technique (and how joints are loaded)
All are important and things I consider myself when working with a new client who’s shoulder isn’t feeling great. However, there’s one “thing” that’s often overlooked in lieu of all the above:
Can the shoulder blade move freely on the ribcage?
The Key to Shoulder Health = Scapular (and Ribcage) Movement
The shoulder blades are meant to move, plain and simple. Nothing extraordinary there.
Upward/downward rotation
Protraction/retraction
Anterior/posterior tilt
The ability to perform all of those actions is indicative of a “healthy” shoulder, and the platform for all that movement to take place come courtesy of the ribcage.
The ribcage is shaped in a convex manner.
The scapulae (shoulder blade) is concave, or rounded, in nature. The ability for the two to play nicely together is an often overlooked mechanism of what I like to call “my shoulder fucking hurts syndrome.”
Here’s a common example of what I mean.
The cue “pull the shoulder blades together and down” is a common one we use in the industry. And, you know what? It works splendidly when 1) you’re working with someone who’s stuck in a more flexed/rounded/computer guy posture and/or 2) the goal is to lift as much weight as humanly possible.
I.e., good luck bench pressing (or even squatting/deadlifting) appreciate weight with shoulder blades that aren’t “set” in a more stable position
That being said, too much of anything can have its inherent drawbacks.[footnote]Except LOLCat memes and foot massages.[/footnote].
The “together and down” cue can lead to overactive lats and a more extension-based pattern where the shoulder blades get stuck or cemented together – making it all the more more challenging for them to move about the rib cage.
My shoulder blades basically making out
To that end one of my favorite ways to address this is to include more reaching drills into people’s training repertoire. That and BACK EXPANSION.
More to the point, what I’m really after is targeting the Serratus Anterior, or those finger-like looking thingamajiggies on the side of your ribs.
I’m starting to fall into the camp that addressing Serratus weakness is the answer to everything:
Shoulder pain?
Neck pain?
Back pain?
Snowblower won’t start?
More Serratus work my friend!
The power of reaching cannot be understated. That in concert with learning to expand the upper back (getting the ribcage to move, via breathing) can be a game changer for a lot of people.
Here’s an effective drill that addresses both.
Seated 1-Arm Reach-Row
Who Did I Steal It From? – Strength coach Conor Harris.
What Does It Do? – Via Conor himself:
“A stiff ribcage is one that lacks trunk rotation and the ability to expand with air. We can free up the ribcage through alternation + reaching of the arms (serratus/obliques) with an intention to pause and expand it posteriorly with air”
The reach engages the serratus/obliques (watch out for that side cramp) and closes off the front side of the body. Air has no where else to go but BACK; it feels wonderful.
Key Coaching Cues: Don’t be a hero. You DO NOT need a lot of weight to perform this exercise, it’s not the point. You’ll pull with one side (elbow to hip, no further) as you simultaneously reach with the other, free hand. From there, inhale through the nose, focus on “breathing into your back,” and then perform a full exhale.
Don’t rush the breaths.
Hold the position for a 2-3 breath count and that’s one repetition.
The third and final installment of my “30 Days of Shoulders” series went live today over at T-Nation.com. All three parts cover everything from shoulder assessment and tips on shoulder friendly pressing t0 how to improve shoulder health and performance.
Collectively it’ll make all your hopes and dreams come true.
I’m willing to bet that if you’re reading this if you have two shoulders.[footnote]Or, I don’t know, maybe you’re a ghost and you don’t have shoulders? It’s still pretty cool you’re reading this though…welcome![/footnote]
I’m also willing to bet that, given the two shoulder scenario, and given this is a blog dedicated towards strength & conditioning, you’re interested in:
Keeping your shoulders healthy.
Making your shoulders stronger.
Building shoulders that resemble boulders.
Argon. You know just because it’s a cool element.[footnote]And because it’s so closely resembles Aragorn, from Lord of the Rings.[/footnote]
It’s more like an amuse bouche or bite-sized commentary on a pet peeve of mine: Fitness professionals who place waaaaay too much emphasis on it (often times to the detriment of the client/athlete).
As well as a scenario where we might pay a little closer attention to it.
A more downwardly rotated scapular position (depression).
An “interesting” shade of blue on the walls.
Now, to be clear: I am NOT someone who places a ton of credence on one’s static posture. While we’re getting better of late, I think the industry as a whole has gotten into a bad habit of placing all if its eggs into the posture basket…
…labeling people as dysfunctional the second we see forward head posture or a hair that’s out of place.
I’ve witnessed some coaches reaching for their “corrective exercise” bag of tricks before they’ve even seen the person they’re assessing do anything:
“Okay Mr. Smith, I notice you exhibit a slight kyphosis in your upper back, your right shoulder is a bit internally rotated, and it looks as if your left eyeball is lower than the right.
Weird.
But here’s the deal: You should purchase a 424 pack of training, and maybe, just maybe, after 62 weeks of dedicated corrective training where we dive deep into some transverse fascial line reactive neuromuscular breathing techniques we’ll be able to progress towards looking at a barbell.
This is not to short-change the importance of someone’s static posture and the information you can glean from it. Of course, if someone walks in with a lengthy injury history and it hurts to blink, then, yeah, it’ll have a bit more weight.
However, we can’t assume that just because a particular person presents with “y” – posturally speaking – that that automatically means “x.” I’ve seen some individuals walk in for their initial assessment with questionable (textbook) posture only to reveal the cleanest health history you’ve ever seen.
Zero injuries. Zero discomfort. Zero fucks to give.
Static posture is nothing more than information.
No one is a walking ball of fail because he or she presents a certain way.
Besides, we also need to respect that “good” or “bad” posture is relative to the load in addition to the task at hand. The latter point is especially cogent to the conversation because as my good friend Alex Kraszewski notes in presentation for The Trainers’ Toolbox:
“Posture/position will govern where motion is available from, as well as who much and where load is distributed. The task will dictate the appropriate range of posture available.”
How I want someone to “look” when attempting a challenging set of deadlifts is quite different compared to someone who’s just sitting there in front of me, sitting.
What’s more,
Anyway, back to the original picture above.
You forgot didn’t you?
Here, this one:
This is a very common theme or resting “presentation” amongst athletes – especially overhead athletes – as well as fitness professionals who 1) stand a lot during the day and 2) lift heavy things for a living.
Again, nothing is cemented as an absolute here, but if an individual walks in complaining of shoulder pain, and you ask him/her to take off their shirt (don’t be creepy about it) and their shoulder blades rest in a more retracted and downwardly rotated position, we can deduce that said individual (may, not always) need to work on more protraction to nudge them back to a more neutral position.
Neutral Scapular Position = Superior/inferior border of the scapulae rests between 2nd-7th thoracic vertebral levels, medial border is ~1-3″ from midline.
Photo Credit: MikeReinold.com
Someone “locked” in a more downwardly rotated position will almost always have a hard time achieving ample scapular UPWARD rotation (protraction is part of this equation), which is kind of a big deal for overall shoulder health & performance.
But don’t assume, you should check.
This is why it’s crucial to include both load AND movement in the initial assessment; sometimes scapular position will clean up on its own with minimal intervention.[footnote]Who are you? Gandalf?[/footnote]
But let’s assume it doesn’t, and the person has been complaining of shoulder ouchies.
What then?
Here are a few drills I like to use and I offer for your consideration:
NOTE: I will say the bigger umbrella theme here is addressing ribcage/thorax position. The position of the shoulder blades are at the mercy of the T-spine.
1. Deadbug w/ Reach
I have a crush on deadbugs and their infinitesimal variations.
They’re a bonafide rockstar when it comes to improving anterior core strength and lumbo-pelvic control (which comes in mighty handedly when you’re working with someone who’s stuck in a more extended position).
Simply “reach” towards the ceiling as you extend your legs towards the floor and perform a FULL exhale with each repetition.
2. Deadbug w/ Loaded Reach
Same as the above, but now we add a smidge of load in the form of a med ball, kettlebell, dumbbell, a basket of He-Man figures, anything.
Sometimes adding a very slight load here can help clients/athletes “feel” the protraction more.
3. Quadruped Band Protraction – off Foam Roller
This is a drill I stole from my good friend and business partner, Dean Somerset.
He’s Canadian.
4. Forearm Wall Slides – off Foam Roller
1. You can blame my buddy Justin Kompf for the verticalness of this video.
Amateur hour.
2. This was/is a staple exercise from my days at Cressey Sports Performance. Start with a foam roller against the wall with your forearms against the foam roller. Protract (push away) from the foam roller and then slide up the wall making sure not to crank into your lower back and flair your rib cage.
Excellent strength coach, and outstanding Canadian, Dean Somerset once stated in an internet post, or maybe it was a blog, “there is always a cost of doing business.” He meant it as a point of emphasis when talking about the various effects of training programs and specific exercises. But he also could have extrapolated it outwards to reflect the stresses of our daily lives.
Poor posture while seated for twelve hours is going to have a cost associated with it just as German volume training.
Note From TG: OMG, German Volume Training brings back the worst memories. I don’t know which was worse: getting kicked on the balls or GVT?
For this reason, the fitness industry has made a major shift towards corrective exercises. Once seen as the tools of progressive physical therapists – these mobility, stability, and integrated exercises have become critical elements in training programs for elite athletes, nimble geriatrics, and the average Joe and Jane alike.
The growth of corrective modalities in conventional personal training is a good thing overall. However, as I pointed out in the introduction to this article series – HERE – there exists a very big downside to the obsession with movement perfection and body correction.
There needs to be a better way of correcting people’s movement flaws, overcoming their specific weaknesses, and getting them to a place where they can safely train hard. Far too many coaches are “under-training” their clients because they are investing too much time “correcting” things. At some point we need to get people training hard towards their actual goals.
Using Your Head For Their Shoulders
There may be no part of the body more susceptible to under-training than the shoulders. With multiple skeletal structures, a bunch of muscle attachments, and a relationship with the spine – there are a lot of reasons that someone wouldn’t be “allowed” to train hard with their shoulders.
Training them includes more than the traditional bodybuilding approach too.
The glenohumeral joint is involved in all upper body pushing and pulling motions as well as the specific isolation exercises that are popular in bodybuilding programs (such as lateral raises or chest flyes). The scapula and clavicle are too, but their positioning on the body also impacts movement such as the deadlift and squat.
Because of their high level of integration with every exercise we do, the shoulders are often the most banged up part of a client’s body. Our poor postures and ill-advised training programs aren’t helping us. Often the two compound each other and only worsen any dysfunction that exists.
Hence the need for correctives.
Really though, the shoulder itself is a bit of a miracle joint – with all the muscles that cross it, the fascia, the nerves, blood vessels, and obvious skeletal structures – it is amazing that it functions as well as it does.
But there can be a whole host of issues going on, or there can be just one. And that is what is most challenging about assessing and correcting shoulder dysfunctions.
It could be as simple as improving someone’s ability to retract and depress their scapula, such as when someone’s posture isn’t where we’d like it.
Or as complex as improving external rotation of the humerus while also stealing more extension from the thoracic spine and stability from the scapula during upward rotation and elevation, such as when a client wants to get better at pull-ups.
No matter how intense the problem is it is important that we as coaches keep our processes simple.
Removing the Restrictions
Yet, simple is not how most coaches approach shoulder health.
In fact, if you were to follow many of the conventional prescriptions that are floated through the industry, then you’d avoid many of the things that produce big results for your clients in favor of small correctives that make small changes. While some clients do need more intervention with these corrective methods – most simply need enough to create an opportunity for more intense training.
If you were to follow many of the guidelines that accompany something as notable as the Functional Movement Screen (the FMS), then many of your clients would not be allowed to press, or pull vertically, or load up abduction or adduction in the frontal or transverse planes until they were able to get a “2” on the shoulder mobility assessment.
While Gray Cook and Lee Burton did an incredible job creating a screening tool that helps coaches discover dysfunction and lack of movement prowess – they also created a system that is preventing a lot of clients from actually getting better.
Note From TG: For anyone interested (I.e., everyone) I wrote about my experience taking the FMS and what I took from it HERE.
The protective measures and governing principles of systems put the fear of God in personal trainers who use them. Many are afraid of loading anything until they see a two on the scoreboard. It is a steady dose of low intensity or no intensity correctives until that day.
Which is where the problem with corrective exercises starts:
Low to no intensity corrective exercises aren’t why clients improve over time. Instead, it is the strengthening exercises that come after these correctives that matter most.
If we are to improve how we utilize corrective exercises in our programs, then we must be willing to accept that what we now know isn’t perfect. We must be willing to entertain the idea that there is a better way of doing business. It is this exact mentality that drives innovation in technology.
It will drive innovation in fitness if we let it.
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(It is important to pause here and make a statement – this article is not meant to treat, diagnose, or prescribe methods or modalities for someone who is dealing with diagnosed injury or dysfunction in their shoulders. Traumatic injuries, conditions such as frozen shoulder, cervical kyphosis, and others require a finer touch from qualified medical professionals.)
If Not This, Then What?
Corrective exercises are like the bore that drills tunnels in the side of a mountain. They create the space for the construction to take place, but they aren’t the construction. You wouldn’t want to drive through a tunnel that hasn’t been reinforced with steel supports and millions of pounds of concrete, so why do you think that corrective exercises are enough to create a finished product in fitness?
The mobility and stability exercises that we define as “correctives” simply create the space for more optimal change to take place. They create the opportunity for well-selected strength exercises to change the tissues for the better.
For shoulder health we find that the classic approach of wall-angels, thoracic roll-overs, and cat-cows are simply creating the opening for which exercises like loaded carries, supinated pulldowns, and banded retractions fill with strength and stability. Our goal needs to be to do enough to get to the exercises that stimulate adaptation and create positive change; in the shoulders and in the rest of the client’s body.
Our responsibility as trainers is to help our clients overcome dysfunctions and improve their movement quality – sure. But our job also implies that we help our clients burn calories, build muscle, and come just short of conquering the universe.
Before diving into the actual corrective exercises that will open the gates for us to train with the intensity our client’s want and need, let’s ensure that everyone reading is on the same page on the anatomy and physiology of the shoulder joint.
The Basic Anatomy and Physiology – Skeletal
When looking at the shoulder joint you are presented with three major bones: the clavicle, the scapula, and the humerus.
The clavicle (or collarbone) is the most stationary of all of these structures, but its lateral aspect does elevate and depress in reaction to movements of the other bones. The humerus, the upper arm bone, is designed for external and internal rotation within the socket – known as the glenohumeral joint.
The humerus can move through flexion, extension, abduction and adduction, and horizontal abduction and adduction by rotating around the glenohumeral joint in each of the three planes (sagittal, frontal, transverse). These movements are aided by the function of the scapula.
The scapula (or shoulder blade) is the large bone in the back of the body. It is capable of six motions: elevation, depression, upward rotation, downward rotation, protraction, and retraction. These movements are also correlated to the three planes of motion too – sagittal, frontal, and transverse respectively.
The spine is also involved in shoulder mobility and stability is often left out when looking at function. We will explore this relationship in the next section when we begin looking at how core function can impact shoulder mobility as well as how thoracic extension is necessary for optimal function of the shoulder joint.
The Basic Anatomy and Physiology – Muscular
The human shoulder functions as incredibly as it does because of the incredible number of muscles that are involved. Some control the humerus, others control the scapula, and others control the spine.
Most of these muscles are found in the back.
When looking at the muscles that contract at the shoulder, we must separate the muscles that control the external rotation and internal rotation of the humerus from the muscles that create the six motions of the scapula. While some muscles share functions – it is important to identify its primary action and what it acts upon in order to better understand how the shoulder wants to function.
The four muscles of the rotator cuff are most responsible for the external and internal rotation capacity of the humerus.
There is evidence to support that the triceps are involved in external rotation, especially under load (just turn your arm around as far as you can right now, and you’ll feel the lateral head of the triceps contract). Therefore, the triceps join the supraspinatus, infraspinatus, and teres minor as external rotators of the humerus.
With that claim we can also ascertain that the biceps and pectoralis group are involved to some degree in internal rotation (although there is significantly less IR available at the shoulder joint). The subscapularis is the internal rotator of the cuff.
When examining the muscles that move the scapula, we are simply looking at the muscles of the upper back; the lats, teres major, rhomboids, trapezius, levator scapulae, the serratus and the three external rotators of the cuff. Each of these muscles have specific functions on pieces of paper, but it is imperative as coaches that we realize that most exercises performed in a gym setting involve more than just one of these muscles doing one of these functions.
It is easy to point at the traps and say “oh, they are elevators and contribute to upward rotation.” It is less easy being able to look at a flawed motion and know exactly what is wrong:
For example, many coaches will point at someone having issues with retraction and think “ah, the upper traps are overactive and the teres major/minor need strengthening.” They could be right and probably are in a population of people who sit with rounded thoracic spines and internally rotated shoulders.
Add in forward neck and shrugged shoulders and this “diagnosis” seems spot on.
However, getting just the teres group to fire without activating the infraspinatus or supraspinatus is nearly impossible in a traditional training setting. Getting someone to stay out of their upper traps sounds like a great coaching cue, but that requires getting them to fire the muscles that contribute to scapular depression; the lower traps, pectoralis minor, and latissimus dorsi at the same time – something most clients (or you) can’t do consciously.
In fact, a lot of scapular depression comes from the ability to put the thoracic spine into extension. Doing so involves activation the lowest fibers of the traps, the lats, the upper abdominals, and a whole host of muscles that are so deep and connected to the individual vertebrae that considering them in training is pointless.
When these muscles contract and thoracic extension takes place, you find that the scapula better slide into the depressed position.
The Core Connection
Yet, thoracic control isn’t completely isolated either.
It is very hard to contract the thoracic muscles without some level of core control. In this instance, the core includes the anterior muscles of the core that we know (rectus and transverse abdominals, internal and external obliques, and Psoas Major.
It also includes the muscles of the posterior core: the quadratus lumborum and the erector spinae.
Conscious contraction of these muscles allows for the core to hold tension, which better stabilizes the lumbar spine, which better allows the thoracic spine to go into extension, which better allows the scapula to depress, which better allows the humerus to externally rotate. As you can see, everything is connected, which is why we can’t use such generic correctives to solve complex problems.
A Less Important Factor?
You’ll notice that we haven’t yet mentioned the deltoid – the most known shoulder muscle. For all the attention it gets in bodybuilding circles its function is not as critical to shoulder function as you’d believe. The anterior fibers assist in internal rotation and drive flexion of the arm while the posterior fibers aid in external rotation and initiate horizontal abduction. The lateral fibers function to create abduction of the arm in the frontal plane.
From a corrective standpoint, it is very rarely an issue with the deltoid that proves to be the problem. In fact, it is often the overdevelopment of the deltoids and upper traps and underdevelopment of the rotator cuff muscles that create impingement issues in dedicated lifters. Great corrective exercises keep the deltoids involved and avoid shutting them out.
The Hidden Gem
In recent years we’ve come to learn that the fascia in our bodies is more than just a covering and more than just extra tissue that gets cut through in surgery. It is a living tissue that is involved in our function on a day by day and minute by minute basis.
In fact, research from Michol Dalcourt and the team at the Institute of Motion have proven that the fascia can communicate information across the body faster than any muscle tissue. Its ability to compress and expand is crucial for athletic development.
Unfortunately, many fitness professionals see it as tissue that is addressed with foam rollers, lacrosse balls, and other release methods. This isn’t wrong of course as these implements can do well to increase blood flow, increase hydration of the fascia, and improve mobility of the joint in question. However, we can also train our fascia just as we train our muscles. We must look to incorporate the variety of slings that Thomas Meyer’s discusses in his text Anatomy Trains.
In our solutions section we’ll explore a few ways to do that to improve the function of the shoulders and truly correct any issues that exist.
But first, we must identify a few of the most common problems.
Common Problems
1) Desk Posture (UCS)
The most common problem that a client will present in regard to their shoulder health is the classic “desk posture”. The scapula sits in protraction and elevation while the humerus’ are internally rotated. This posture is held for eight, ten, and twelve hours a day. Over time the pectoralis muscles get tighter, the trapezius muscles lengthen, the muscles of the scapula and glenohumeral joint get weaker, and the client continues to worsen.
The most advanced form of this condition is known as Upper Cross Syndrome (UCS) – a severe condition of immobility that usually involves additional intervention with physical therapists, and sometimes, orthopedic surgeons. This posture often presents forward neck as a well – a dangerous condition of the cervical spine.
The treatment for individuals in this position is to correct their posture and work to move them in better retraction, depression, and external rotation. However, many of the common methods do not provide enough intensity to stimulate muscle growth or strength adaptations in the muscles of the upper back. It is crucial for trainers to invest time in building their clients upper backs and coaching optimal patterns if the corrective interventions are ever going to stick.
2) Poor Scapulohumeral rhythm
For many people the pain they experience in their pressing and pulling motions is a result of a poor pattern being present. Of course, there are others who have legitimate issues such as shoulder impingements, strained muscles of the rotator cuff, or overactive trapezius muscles that make doing certain movements nearly impossible. The rest though, simply need help reworking their patterns and an emphasis on strengthening the muscles that control those patterns.
The scapulohumeral rhythm refers to the quality of movement that occurs when we consider the scapula and glenohumeral joints interaction. People with great rhythms typically an exercise pain-free while people who lack control and patterning struggle to accomplish even the most basic tasks.
This topic is quite deep, but in short realize there is a relationship between the position of the humerus and where the scapula “should” be.
For example, in a traditional dumbbell overhead press the scapula should be upwardly rotating and elevating as the humerus adducts towards the midline at the top of the press. Many people will execute their press and have little to no movement out of their scapula, thus causing increased stress on tissues that shouldn’t need to encounter them.
3) Lack of External Rotation
One of the issues many clients face is the inability to rotate their humerus back. This is more than just the presence of too much internal rotation (such as with U.C.S.). The muscles responsible for external rotation of the shoulder are powerful muscles that also engage in the motions of the scapula. Lacking strength in these tissues can cause someone to become more internally rotated, but also makes it incredibly hard to achieve external rotation at the glenohumeral joint.
This matters for more than just mobility.
Popular exercises such as pull-ups require a person to own a certain amount of external rotation in order to execute the motion. So too does the overhead press. Lacking the ability to achieve optimal end range of E.R. makes both movements, and so many others, hard to accomplish.
It is important to understand that the exercises we use to improve external rotation put the humerus in a greater rotation than we would normally encounter in traditional lifting. But, this sort of work is necessary to strengthen and stimulate the muscles that create E.R. and maintain it in an isometric contraction (such as during a overhead press).
4) Weak Core and Poor Thoracic Extension
As stated earlier, the core and spine play a major role in whether the shoulders function optimally. A lot of lifters never develop optimal shoulder health because they create mobility by overextending their lumbar and thoracic spine to compensate. This is especially prevalent in ego lifters performing an overhead press with a massive amount of “layback”.
Lacking the ability to contract the anterior core and stabilize the lumbar spine makes it significantly harder for someone to master true thoracic extension. The ability to lift the ribs and extend the thoracic spine allows for better depression, retraction, and downward rotation of the scapula. These motions are direct opposites of the posture that many fall into as a result of upper cross syndrome or “desk posture”.
Strengthen the abdominal wall and muscles of the T-spine is imperative to optimizing shoulder function. Much like the foundation of a skyscraper must be firm and set underneath the construction, so too does our core and spine for our shoulders.
5) Weak Upper Back and Lack of Awareness
In a lot of cases, especially in individuals who do not regularly engage in an exercise plan, there is simply a lack of proprioception and strength in the muscles that control the scapula and glenohumeral joint. Often, there is nothing “wrong” with this population other than their lack of sensory awareness and force production capabilities.
Clients like this require more exposure to well-coached patterns and a progressively overloaded strength program that allows their muscles to adapt over time. It may be beneficial to use low intensity correctives to prime a specific pattern and create mobility in the joint prior to loading the muscles with traditional methods.
It is critical that we stop seeing all clients as wrecked when they are unable to perform a specific task. For many people, especially with something as obscure as the FMS, it is simply an unfamiliarity with their body and the demand you are placing upon them. Increase their exposure to well-coached exercise instead of trying to fix something that isn’t broken.
New Solutions
As we dive into the specific movements it is important for us to realize that these are just a few examples of great movements that can be used to strengthen and stabilize the shoulder joint. Some of these movements are common and others are painfully boring (in a sense that we aren’t shaking the Earth).
However, simplicity is often the fasted route to success.
A few of these movements are going to be outside the realm of normality for some coaches. Many traditional strength coaches would look at Animal Flow as a weird form of yoga and dancing, but it is that arena that brings the fascia into the fold. Other movements are simply manipulations of variables in the training arena, such as the angled press, that most people aren’t considering.
1) Dual Kneeling Band Pull Apart
https://www.youtube.com/watch?v=3rrHNDcVa9s
The band pull apart is nothing new.
However, adding in the kneeling position asks us to contract our core and our glutes – two major parts of our foundation. In doing so we can better extend our thoracic spine, which in turn allows for better retraction of the scapula.
2.1) The Full-House (2 Cables/3 Motions)
https://www.youtube.com/watch?v=COSRT7nPTPc
This multi-pattern movement asks for retraction of the scapula, then retraction into downward rotation and depression (with external rotation of the humerus). Lastly, the overhead press asks for elevation, upward rotation, and forces the external rotators to fire hard to prevent the arms from collapsing forward of the line of gravity.
This sort of movement is incredible for grooving the scapulohumeral rhythm, improving upper back strength, and increasing external rotation of the humerus. It is quite the challenge and needs to be done extra light. Five pounds was the resistance in the videos.
2.2) Second View
https://www.youtube.com/watch?v=Qt8ex9TL8GQ
3) External Rotated T, Y
https://www.youtube.com/watch?v=3Juj1iYiJFE
A simple variation of traditional T and Y – this a movement that can be used to improve retraction of the scapula while strengthening the external rotators. It forces the trainee to own their humeral position and originate movement from the glenohumeral joint while remaining set onto stable scapula.
This exercise also promotes additional thoracic extension.
4) Angled Press
https://www.youtube.com/watch?v=FVPsVXWXds0
Far too many people contraindicate the overhead push pattern when someone is dealing with shoulder dysfunction. If we were to listen to the FMS, no one who can’t get a two on the shoulder mobility exam should ever press overhead. Yet, tons of people can press pain-free without getting a two.
This exercise helps bridge the gap between overhead pressing and not. The slight angle (about 15 degrees) allows you to load up the deltoids a bit without creating a perfect opposition to gravity. The neutral grip, forward elbow, and emphasis on tempo allows us to focus on scapulohumeral rhythm. Use this as a primary exercise after preparing clients for their workouts. This will correct a lot of flaws so long as the movement remains pain free.
5) Supinated Pulldowns
https://www.youtube.com/watch?v=TbIy3pH0nlo
At first glance this looks like a standard, boring pulldown.
Yet, it is the dramatic emphasis on depression and elevation of the scapula that makes this one stand out. Far too many folks get on the pulldown and just start yanking on the bar to get their set done. The motion becomes about completion instead of optimization.
The supinated hand grip helps keep the humerus in a slightly more externally rotated position while also prevented much of the internal rotation that happens with heavy pronated pulldowns. The focus here is to emphasize absolute end ranges. Feel the scapula elevate while maintaining control and then drive them downwards into full depression at the bottom.
6) Simple Animal Flow (Beast Hold to Scorpion to Alternating Crab Reaches)
https://www.youtube.com/watch?v=x27wT-nxUkg
A lot of you will look at this and wonder – why in the heck am I going to do all that flailing? Yet, animal flow is an incredible discipline that emphasizes loading of a lot of our passive structures – the fascia, the connective tissue, the skeletal system. Strengthening these things is imperative to the absolute realization of healthy shoulders. Specifically, the external rotation of the humerus in set crab position is a great tool to have in your arsenal.
7) BONUS: New Way to do Chest Flyes
https://www.youtube.com/watch?v=hcRTVz4aWOE
Lastly, I want to share the new best way for you to execute chest flyes.
See, the chest flye is one of the most favorite exercises in bodybuilding culture. It causes a tremendous stretch of the pec fibers and can help the person doing them build the muscle they crave. Yet, there is a ridiculous amount of sheering force placed upon the shoulder joint when the dumbbells reach the bottom of a traditional flye.
So, instead of using dumbbells and pissing off your shoulders – integrate this band only variation. The key is to press out into the band for the entirety of the movement, thus keeping a high level of tension on the working muscles without stressing the shoulder joint against gravity. As you fatigue shorten the range and focus on the squeeze.
Putting It All Together
You can correct someone’s shoulders and move their fitness forward at the same time. Your job as a fitness professional is to drive your clients towards the results they want and the results they didn’t know they need. You can still use low intensity correctives in your programs, of course, but it is imperative to go forward understanding that they are simply a very small piece of a much larger puzzle. Your client, if they are to improve, must begin strengthening the muscles by training the appropriate patterns that address shoulder health.
Next: The Lower Back and Pelvis
In the next article we’ll explore the lumbar spine, pelvis, and anterior core and how we can better correct chronic low-level back pain, coach better hinge patterns, and improve our client’s ability to move with confidence.
